中国全科医生资源配置的动态演变及影响因素研究——基于Kernel密度估计和空间计量经济模型  

Study on the dynamic evolution and influencing factors of general practitioner resource allocation in China-based on Kernel density estimation and spatial econometric model

作　　者：姜城蕾 宋国强[1,2] 邱林萍 刘梦 孙先红[1,2] JIANG Cheng-lei;SONG Guo-qiang;QIU Lin-ping;LIU Meng;SUN Xian-hong(Hospital Management Institute,School of Health Management,Anhui Medical University,Hefei,Anhui 230032,China;不详)

机构地区：[1]安徽医科大学卫生管理学院,安徽合肥230032 [2]安徽医科大学医院管理研究所

出　　处：《现代预防医学》2024年第22期4153-4158,共6页Modern Preventive Medicine

基　　金：医疗健康领域人力资源配置水平和公平性分析预测研究项目(2023gykj10);医疗健康数据建模分析及医疗健康大数据案例的研究项目(K2022072);产学研合作项目(K2021148)。

摘　　要：目的从省域角度探索弥补全科医生资源缺口以及分布不均的策略,以满足人民不断增长的医疗需求,推进医疗卫生体制改革。方法基于2013—2022年省级全科医生数据,采用Kernel密度估计揭示全科医生资源的动态演变特征,运用空间自相关方法探索全科医生资源的空间相关特征,采用空间计量经济模型探索全科医生资源影响因素的直接影响与溢出效应。结果我国全科医生资源存在正向自相关性。直接效应中,城镇化率和人口密度对全科医生资源存在正向影响,老年人口抚养比存在负向影响;间接效应中,城镇化率、人口密度、医疗卫生支出占财政支出的比重、医疗卫生机构数均对全科医生资源存在负向影响。结论我国的全科医生资源在空间上不是随机分布的,邻接地区影响因素的溢出效应也会对全科医生资源产生影响。建议注重不同区域间的医疗资源协作和医疗政策协调,促进跨地区全科医生的交流和共享。Objective To explore strategies to address the gap and uneven distribution of general practitioner(GP)resources from a provincial perspective,aiming to meet the growing medical needs of the people and advance the reform of the medical and health system.Methods Based on the provincial GP data from 2013-2022,Kernel density estimation was used to reveal the dynamic evolution of GP resources,while the spatial autocorrelation method was applied to explore their spatial correlation characteristics.Additionally,a spatial econometric model was used to investigate the direct impacts and spillover effects of the factors influencing general practitioner resources.Results There is a positive autocorrelation in China’s general practitioner resources.Among the direct effects,urbanization rate and population density have a positive impact on general practitioner resources,while the elderly dependency ratio has a negative impact.In terms of indirect effects,urbanization rate,population density,the proportion of medical and health expenditure in fiscal expenditure,and the number of medical and health institutions all have a negative impact on general practitioner resources.Conclusion General practitioner resources in China are not randomly distributed spatially,and the spillover effects of influencing factors in adjacent areas can also impact general practitioner resources.It is recommended to focus on collaboration of medical resources and coordination of medical policies among different regions,promoting cross-regional communication and sharing of general practitioners.

关 键 词：全科医生 Kernel密度估计 空间计量经济模型 动态演变 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]